Centers for Disease Control and Prevention

National Center for HIV, Viral Hepatitis, STD, and TB Prevention

Tuberculosis (TB) in the United States

1993–2022*

Division of Tuberculosis Elimination

National Tuberculosis Surveillance System

*Data updated as of July 8, 2023
Progress Towards TB Elimination, United States, 1982–2022

0

5000

10000

15000

20000

25000

30000

1982 1986 1990 1994 1998 2002 2006 2010 2014 2018 2022

Number of cases

Year

Elimination threshold: ~330 cases or <1 case per 1,000,000 population

26,673 TB cases in 1992

Incidence rate: 10.4 per 100,000

8,331 TB cases in 2022

Incidence rate: 2.5 per 100,000
TB Cases and Incidence Rates, United States, 1993–2022

0

2

4

6

8

10

0

5,000

10,000

15,000

20,000

25,000

1994 1998 2002 2006 2010 2014 2018 2022

Cases per 100,000 persons

Number of cases

Year

 Number of cases Incidence rate

8,331 TB cases in 2022

Incidence rate: 2.5 per 100,000
3.6 3.4

3.2 3.0 2.9 3.0 2.9 2.8 2.8 2.7

2.2 2.4 2.5

0

1

2

3

4

Cases per 

100,000 persons

TB Incidence Rates and Annual Percent Change in Rate, 

United States, 2010–2022

-4.5 -6.1 -6.1 -4.6 -2.1

0.9

-3.8 -2.5 -1.3 -1.6

-20.2

9.6

5.5

-25

-15

-5

5

2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022

Annual percentage 

change in rate

*

Year *Annual percent change in rate based on unrounded data
TB-Related Deaths* and Mortality Rates, United States, 1993–2021

0.0

0.1

0.2

0.3

0.4

0.5

0.6

0.7

0

400

800

1,200

1,600

2,000

1993 1997 2001 2005 2009 2013 2017 2021

Deaths per 100,000 persons

Number of deaths

Year

Number of deaths Mortality rate

*National Vital Statistics System Underlying Cause of Death (based on deaths reported through 2021)

602 TB-related deaths in 2021

Mortality rate: 0.2 per 100,000
TB Cases by Reporting Area, United States, 2022

Texas 

13%

California 

22%

New York*

9%

Number of TB cases

≤99

100–299

300–999

≥1000

Florida 

6%

* Includes New York City
TB Incidence Rates* by Reporting Area, United States, 2022

Texas

3.7

California

4.7

New Jersey

3.1

New York

3.6†

*Cases per 100,000 persons

†Includes New York City

Hawaii

7.0

Alaska

13.0

1.5–<2.5

≥4.5

2.5–<4.5

Incidence rate

<1.5

Washington

3.2

Maryland

2.5
TB Cases and Incidence Rates*

by Reporting Area, United States, 2022

*Cases per 100,000 persons

≥3.4

1.7–<3.4

<1.7

Incidence rate*

Case count
TB Incidence Rates* by U.S.-Affiliated Pacific Islands, 2022

*Cases per 100,000 persons

†American Samoa data not submitted for 2022

Guam

34.9

Federated States 

of Micronesia

45.1

Republic of Palau

38.8

Northern 

Mariana Islands

44.7

Republic of 

Marshall Islands

252.1

American Samoa

Data not available†
TB Cases and Incidence Rates by Origin of Birth,*

United States, 1993–2022

0

5

10

15

20

25

30

35

40

0

5,000

10,000

15,000

20,000

25,000

30,000

1994 1998 2002 2006 2010 2014 2018 2022

Cases per 100,000 persons

Number of cases

Year

 U.S.-born persons (2022: n=2,142)

Non-U.S.–born persons (2022: n=6,148)

 U.S.-born rate (2022: 0.8 cases per 100,000)

Non-U.S.–born rate (2022: 13.0 cases per 100,000)

*Persons born in the United States, certain U.S. territories, or elsewhere to at least one U.S. citizen parent are categorized as U.S.-born. All other persons are categorized as non-U.S.–born.
0.0

0.4

0.8

1.2

1.6

2.0

2012 2014 2016 2018 2020 2022

Cases per 100,000 persons

Year

U.S.-born

2% decrease from 

2021 to 2022

TB Incidence Rates by Origin of Birth,* United States, 2011–2022 

0

4

8

12

16

20

2012 2014 2016 2018 2020 2022

Year

Non-U.S.–born

*Persons born in the United States, certain U.S. territories, or elsewhere to at least one U.S. citizen parent are categorized as U.S.-born. All other persons are categorized as non-U.S.–born.

4% increase from 

2021 to 2022
TB Incidence Rates and Percentages by Origin of Birth,*

United States, 2022 (N=8,331)

U.S.-born, 26% 

(Rate: 0.8 per 100,000)

Non-U.S.–born 74%

(Rate: 13.0 per 100,000)

–

*

Persons born in the United States, certain U.S. territories, or elsewhere to at least one U.S. citizen parent are categorized as U.S.-born. All other persons are categorized as non-U.S.–born.

Origin of birth unknown, <1%
TB Cases by Countries of Birth Among Non-U.S.–Born* Persons with 

TB, United States, 2022 (N=6,148)

*Persons born in the United States, certain U.S. territories, or elsewhere to at least one U.S. citizen parent are categorized as U.S.-born. All other persons are categorized as non-U.S.–born.

600 +

N/A

0 - 49

50 - 99

100 - 249

250 - 399

400 - 599

India

9%

Vietnam

8%

Mexico 

19%

China

6%

Philippines

11%
Percentage of TB Cases Among Non-U.S.–Born* Persons by Years 

Since Initial Arrival in the United States at Diagnosis,† 2022 (N=6,148)

17%

14%

13%

8%

7%

9%

6%

7%

4%

10%

<1 year

1-4 years

5–9 years

10–14 years

15–19 years

20–24 years

25–29 years

30–34 years

35–39 years

≥40 years

*Persons born in the United States, certain U.S. territories, or elsewhere to at least one U.S. citizen parent are categorized as U.S.-born. All other persons are categorized as non-U.S.–born.

†The number of years since initial arrival in the United States at diagnosis was unknown or missing for 7% of non-U.S.–born persons. These persons were included in the denominator when 

percentages were calculated.
0

2,000

4,000

6,000

8,000

10,000

12,000

2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022

Number of cases

Year

TB Cases by Race/Ethnicity,* United States, 2011–2022

*Persons who identified as Hispanic or Latino were categorized as "Hispanic," regardless of self-reported race. Persons who did not identify as Hispanic or Latino were categorized by self-reported 

race; if more than one race was reported, the person was categorized as "Multiple race."

Black or African American

Native Hawaiian or Other Pacific Islander

American Indian or Alaska Native

Asian

Multiple Race

White

Hispanic or Latino
Percentage of TB Cases by Race/Ethnicity,* United States, 2011–2022

0%

20%

40%

60%

80%

100%

2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022

Percentage of cases

Year

Black or African American

Native Hawaiian or Other Pacific Islander

American Indian or Alaska Native

Asian

Multiple Race

White

Hispanic or Latino

*Persons who identified as Hispanic or Latino were categorized as "Hispanic," regardless of self-reported race. Persons who did not identify as Hispanic or Latino were categorized by self-reported 

race; if more than one race was reported, the person was categorized as "Multiple race."
Percentage of TB Cases by Race/Ethnicity,* 

United States, 2022 (N=8,331)

34%

34%

16%

10%

2%

1%

1%

1%

Asian

Hispanic or Latino

Black or African American

White

Native Hawaiian or Other Pacific Islander

American Indian or Alaska Native

Multiple race

Unknown or missing

*Persons who identified as Hispanic or Latino were categorized as "Hispanic," regardless of self-reported race. Persons who did not identify as Hispanic or Latino were categorized by self-reported 

race; if more than one race was reported, the person was categorized as "Multiple race."
0

5

10

15

20

25

2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022

Cases per 100,000 persons

Year

Native Hawaiian or Other 

Pacific Islander

American Indian or Alaska Native

Asian

Multiple Race

White

Black or African American

Hispanic or Latino

TB Incidence Rates by Race/Ethnicity,* United States, 2011–2022

*Persons who identified as Hispanic or Latino were categorized as "Hispanic," regardless of self-reported race. Persons who did not identify as Hispanic or Latino were categorized by self-reported 

race; if more than one race was reported, the person was categorized as "Multiple race."
TB Cases Among U.S.-Born* Persons by Race/Ethnicity,†

United States, 2011–2022

0

1,000

2,000

3,000

4,000

2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022

Number of cases

Year

Black or African American

Native Hawaiian or Other Pacific Islander

American Indian or Alaska Native

Asian

Multiple Race

White

Hispanic or Latino

*Persons born in the United States, certain U.S. territories, or elsewhere to at least one U.S. citizen parent are categorized as U.S.-born. All other persons are categorized as non-U.S.–born.

†Persons who identified as Hispanic or Latino were categorized as "Hispanic," regardless of self-reported race. Persons who did not identify as Hispanic or Latino were categorized by selfreported race; if more than one race was reported, the person was categorized as "Multiple race."
TB Incidence Rates Among U.S.-Born* Persons by 

Race/Ethnicity,† United States, 2011–2022

0

1

2

3

4

5

6

7

2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022

Cases per 100,000 persons

Year

Native Hawaiian or

Other Pacific Islander

American Indian or

Alaska Native

Asian

Multiple Race

White

Black or African American

Hispanic or Latino

*Persons born in the United States, certain U.S. territories, or elsewhere to at least one U.S. citizen parent are categorized as U.S.-born. All other persons are categorized as non-U.S.–born.

†Persons who identified as Hispanic or Latino were categorized as "Hispanic," regardless of self-reported race. Persons who did not identify as Hispanic or Latino were categorized by selfreported race; if more than one race was reported, the person was categorized as "Multiple race."
TB Cases Among Non-U.S.–Born* Persons by Race/Ethnicity,†

United States, 2011–2022

0

1,000

2,000

3,000

4,000

5,000

6,000

7,000

2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022

Number of cases

Year

Black or African American

Native Hawaiian or Other Pacific Islander

American Indian or Alaska Native

Asian

Multiple Race

White

Hispanic or Latino

*Persons born in the United States, certain U.S. territories, or elsewhere to at least one U.S. citizen parent are categorized as U.S.-born. All other persons are categorized as non-U.S.–born.

†Persons who identified as Hispanic or Latino were categorized as "Hispanic," regardless of self-reported race. Persons who did not identify as Hispanic or Latino were categorized by selfreported race; if more than one race was reported, the person was categorized as "Multiple race."
TB Incidence Rates Among Non-U.S.–Born* Persons by 

Race/Ethnicity,† United States, 2011–2022

0

10

20

30

40

50

2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022

Cases per 100,000 persons

Year

Native Hawaiian or Other 

Pacific Islander

Asian

Multiple Race

White

Black or African American

Hispanic or Latino

*Persons born in the United States, certain U.S. territories, or elsewhere to at least one U.S. citizen parent are categorized as U.S.-born. All other persons are categorized as non-U.S.–born.

†Persons who identified as Hispanic or Latino were categorized as "Hispanic," regardless of self-reported race. Persons who did not identify as Hispanic or Latino were categorized by selfreported race; if more than one race was reported, the person was categorized as "Multiple race."
TB Incidence Rates Among Non-U.S.–Born and U.S.-Born* Persons by 

Race/Ethnicity,† United States, 2011–2022

*Persons born in the United States, certain U.S. territories, or elsewhere to at least one U.S. citizen parent are categorized as U.S.-born. All other persons are categorized as non-U.S.–born.

†Persons who identified as Hispanic or Latino were categorized as "Hispanic," regardless of self-reported race. Persons who did not identify as Hispanic or Latino were categorized by self-reported 

race; if more than one race was reported, the person was categorized as "Multiple race."

§Non-U.S-born American Indian/Alaska Native are not displayed because some years have zero cases, which cannot be displayed in a log-scale graph.

0

1

10

100

2012 2014 2016 2018 2020 2022

Cases per 100,000 persons

Year

2012 2014 2016 2018 2020 2022

Year

American Indian or

Alaska Native

Asian

Black or African

American

Hispanic or Latino

Multiple races

Native Hawaiian or

Other Pacific Islander

White

Non-U.S.–born U.S.–born §
Percentage* of TB Cases by Origin† and Race/Ethnicity,§

United States, 2022

*Percentages are rounded. 

†

Persons born in the United States, certain U.S. territories, or elsewhere to at least one U.S. citizen parent are categorized as U.S.-born. All other persons are categorized as non-U.S.–born.

§Persons who identified as Hispanic or Latino were categorized as "Hispanic," regardless of self-reported race. Persons who did not identify as Hispanic or Latino were categorized by self-reported 

race; if more than one race was reported, the person was categorized as "Multiple race.”

Non-U.S.–born persons

(N=6,148)

U.S.-born persons 

(N=2,142)

5%

1%

2%

26%

31%

25%

7%

Native Hawaiian or 

Other Pacific Islander

American Indian or 

Alaska Native

Multiple Race

White

Hispanic or Latino

Black or

African American

Asian

1%

2%

5%

10%

37%

44%

0%
TB Incidence Rates* by Origin† and Race/Ethnicity,§

United States, 2022

*Cases per 100,000 persons

†

Persons born in the United States, certain U.S. territories, or elsewhere to at least one U.S. citizen parent are categorized as U.S.-born. All other persons are categorized as non-U.S.–born.

§Persons who identified as Hispanic or Latino were categorized as "Hispanic," regardless of self-reported race. Persons who did not identify as Hispanic or Latino were categorized by selfreported race; if more than one race was reported, the person was categorized as "Multiple race."

Non-U.S.–born persons

(N=6,148)

U.S.-born persons 

(N=2,142)

Native Hawaiian or 

Other Pacific Islander

White

Black or 

African American

Hispanic or Latino

4.5

0.3

6.3

0.3

1.9

1.3

1.8

American Indian or 

Alaska Native

Multiple Race

Asian

0.0

31.2

27.8

3.5

14.0

10.4

22.7 Asian
TB Cases by Age Group, United States, 1993–2022

0

5,000

10,000

15,000

20,000

25,000

1994 1998 2002 2006 2010 2014 2018 2022

Number of cases

Year

≥65 years

45–64 years

25–44 years

15–24 years

5–14 years

0–4 years
TB Cases by Age Group, United States, 2022 (N=8,331)

2%

2%

10%

29%

29%

27%

0–4 years

5–14 years

15–24 years

25–44 years

45–64 years

≥65 years
0

1

10

100

1994 1998 2002 2006 2010 2014 2018 2022

Cases per 100,000 persons

Year

≥65 years

45–64 years

25–44 years

15–24 years

5–14 years

0–4 years

TB Incidence Rates by Age Group, United States, 1993–2022
TB Cases Among U.S.-Born* Persons by Age Group, 

United States, 1994–2022

0

4,000

8,000

12,000

16,000

1994 1998 2002 2006 2010 2014 2018 2022

Number of cases

Year

≥65 years

45–64 years

25–44 years

15–24 years

5–14 years

0–4 years

*

Persons born in the United States, certain U.S. territories, or elsewhere to at least one U.S. citizen parent are categorized as U.S.-born. All other persons are categorized as non-U.S.–born.
TB Incidence Rates* Among U.S.-Born† Persons by Age Group, 

United States, 1994–2022

0

1

10

100

1994 1998 2002 2006 2010 2014 2018 2022

Cases per 100,000 persons

Year

≥65 years

45–64 years

25–44 years

15–24 years

5–14 years

0–4 years

*Population Source: U.S. Census Bureau, Current Population Survey Basic Monthly: https://data.census.gov/mdat/

†

Persons born in the United States, certain U.S. territories, or elsewhere to at least one U.S. citizen parent are categorized as U.S.-born. All other persons are categorized as non-U.S.–born.
TB Cases Among Non-U.S.–Born* Persons by 

Age Group, United States, 1994–2022

0

2,000

4,000

6,000

8,000

1994 1998 2002 2006 2010 2014 2018 2022

Number of cases

Year

0–4 years 5–14 years 15–24 years 25–44 years 45–64 years ≥65 years

*

Persons born in the United States, certain U.S. territories, or elsewhere to at least one U.S. citizen parent are categorized as U.S.-born. All other persons are categorized as non-U.S.–born.
TB Incidence Rates* Among Non-U.S.–Born† Persons by 

Age Group, United States, 1994–2022

1

10

100

1994 1998 2002 2006 2010 2014 2018 2022

Cases per 100,000 persons

Year

≥65 years 45–64 years 25–44 years

15–24 years 5–14 years 0–4 years

*Population Source: U.S. Census Bureau, Current Population Survey Basic Monthly: https://data.census.gov/mdat/

†

Persons born in the United States, certain U.S. territories, or elsewhere to at least one U.S. citizen parent are categorized as U.S.-born. All other persons are categorized as non-U.S.–born.
Percentage of TB Cases by Sex and Age Group, United States, 2022

Males (N=5,157) Females (N=3,144)

63%

65%

61%

59%

46%

52%

36%

35%

39%

41%

54%

0–4 years (N=201) 48%

5–14 years (N=163)

15–24 years (N=845)

25–44 years (N=2,449)

45–64 years (N=2,421)

≥65 years (N=2,252)

Age group
Pediatric* TB Cases by Origin of Birth,† United States, 1993–2022

0

200

400

600

800

1,000

1,200

1,400

1,600

1,800

1994 1998 2002 2006 2010 2014 2018 2022

Number of cases

Year

Non-U.S.–born

U.S.-born

*

Children less than 15 years old

†

Persons born in the United States, certain U.S. territories, or elsewhere to at least one U.S. citizen parent are categorized as U.S.-born. All other persons are categorized as non-U.S.–born.
Pediatric TB Incidence Rates* by Origin of Birth,†

United States, 1994–2022

0

10

20

30

40

50

60

1994 1998 2002 2006 2010 2014 2018 2022

Cases per 100,000 persons

Year

Non-U.S.–born, 0–4 years

Non-U.S.–born, 5–14 years

U.S.-born, 0–4 years

U.S.-born, 5–14 years

*Population Source: U.S. Census Bureau, Current Population Survey Basic Monthly: https://data.census.gov/mdat/

†

Persons born in the United States, certain U.S. territories, or elsewhere to at least one U.S. citizen parent are categorized as U.S.-born. All other persons are categorized as non-U.S.–born.
Percentage of TB Cases by Site of Disease, United States, 2022

Pulmonary only,

70%

Extrapulmonary 

only, 19%

Both, 11%

25%

1%

4%

6%

6%

9%

22%

26%

Other

Laryngeal

Genitourinary

Meningeal

Peritoneal

Bone and joint

Pleural

Lymphatic

Extrapulmonary sites of disease*

(N=2,765)

*Persons might have more than one extrapulmonary site of disease.
0%

20%

40%

60%

80%

100%

1994 1998 2002 2006 2010 2014 2018 2022

Percentage of cases

HRZE† Other 4+ drug regimen§ Not on a 4+ drug regimen

Year

Percentage of TB Cases* by Initial Drug Regimen, 

United States, 1993–2022

*Persons alive at diagnosis with initial drug regimen information.

†H, isoniazid; R, rifampin; Z, pyrazinamide; E, ethambutol.

§A drug regimen with at least four drugs, other than HRZE.

HRZE† Other 4+ drug regimen§
HRZE§

, 81%

Not on a 4+ drug regimen, 6%

Other 4+ drug regimen†, 13%

Percentage of TB Cases* by Initial Drug Regimen, 

United States, 2022 (N=8,045)

*Persons alive at diagnosis with initial drug regimen information.

† A drug regimen with at least four drugs, other than HRZE.

§H, isoniazid; R, rifampin; Z, pyrazinamide; E, ethambutol.
*Persons on an initial drug therapy with at least one drug.

†Most recent year for which data are complete.

§DOT=directly observed therapy; SAT=self-administered therapy.

Percentage of TB Cases by Method of Treatment Administration,* United 

States, 1993–2020†

0%

20%

40%

60%

80%

100%

1993 1996 1999 2002 2005 2008 2011 2014 2017 2020

Percentage of cases

Year

DOT§ only DOT + SAT SAT only Unknown or missing § only DOT and SAT§
Percentage of TB Cases* by Method of Treatment Administration, 

United States, 2020† (N=6,907)

Directly-observed therapy 

(DOT) only, 61.5%

DOT + SAT, 31.0%

Self-administered 

therapy (SAT) only, 5.8%

Unknown or missing, 1.8%

*Persons on an initial drug therapy with at least one drug.

†Most recent year for which data are complete.
0%

20%

40%

60%

80%

100%

1993 1996 1999 2002 2005 2008 2011 2014 2017 2020

Percentage of cases

Year

Completed in ≤1 year Completed in > 1 year Did not complete or duration unknown National 

Goal:§

95%

Percentage of TB Cases* by Completion of TB Therapy,

United States, 1993–2020†

*Persons alive at diagnosis who started TB therapy and for whom therapy <1 year was indicated. 

†Most recent year for which data are complete.

§National goal: for 95% of patients with newly diagnosed TB disease for whom ≤12 months of treatment is indicated to complete treatment within 12 months.
TB Cases Resistant to Isoniazid* by Origin of Birth,†

United States, 1993–2022

0

200

400

600

800

1,000

1,200

1,400

1,600

1,800

1994 1998 2002 2006 2010 2014 2018 2022

Number of cases

Year

U.S.-born

Non-U.S.–born

*Persons with isolates resistant to at least isoniazid among persons with isolates tested with at least isoniazid and rifampin. †Persons born in the United States, certain U.S. territories, or elsewhere to at least one U.S. citizen parent are categorized as U.S.-born. All other persons are categorized as non-U.S.–born.
Number and Percentage of Multidrug-Resistant (MDR)* TB Cases† by 

History of TB, United States, 1993–2022

0%

1%

2%

3%

0

100

200

300

400

500

1994 1998 2002 2006 2010 2014 2018 2022

Percentage of cases

Number of cases

Year

 No previous TB

 Previous TB

 Percentage MDR with no previous TB

*Persons with isolates resistant to at least isoniazid and rifampin among persons with isolates tested with at least isoniazid and rifampin

†Excludes persons with unknown origin of birth
Percentage of HIV Coinfection by Age Among Persons with TB,*

United States, 2011–2022

0%

2%

4%

6%

8%

10%

12%

2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022

Percentage of cases

Year

All ages

25–44 years

45–64 years

*Persons alive at diagnosis with HIV test results
Percentage of Selected Risk Factors Among Persons with TB by 

Origin of Birth,* United States, 2022

24%

1% 1%

10%

17%

1% 1%

10%

27%

1% 1%

9%

Diabetes mellitus Post-organ transplantion TNF-α inhibitors Non-HIV immunosuppression

Total

U.S.-born

Non-U.S.–born 

*

Persons born in the United States, certain U.S. territories, or elsewhere to at least one U.S. citizen parent are categorized as U.S.-born. All other persons are categorized as non-U.S.–born.
Percentage of Social and Behavioral Risk Factors Among Persons 

Aged ≥15 Years with TB, United States, 2022

1%

2%

5%

7%

9%

Injection drug use

Residing in long-term care facility†

Experiencing homelessness

Noninjection drug use

Excess alcohol use

*

Within past 12 months prior to TB diagnosis

†At the time of TB diagnosis

Excess alcohol use*

Injecting drug use*

Noninjecting drug use*

Experiencing homelessness*

Residing in long-term care facility†
Dead at diagnosis

(N=208)

Died after diagnosis

(N=637)†

24%

48%

29%

19%

40%

41% TB cause of 

death

TB not cause 

of death

Unknown 

cause of death

Percentage of TB Cases by Status

and Cause of Death, United States, 2020*

Alive, 88%

(N=6,326)

Dead, 12%

(N=845)

*Most recent year for which data are complete

†Six deaths were related to TB therapy.
Definitions for TB Genotyping in the United States

wgMLST, whole-genome multilocus sequence typing.

More information on WGS is available at https://www.cdc.gov/tb/programs/genotyping/genome-sequencing.htm.
675

139

64

36

17

9

13

7

27

2 cases

3 cases

4 cases

5 cases

6 cases

7 cases

8 cases

9 cases

≥10 cases

Number of County-based TB Genotype Clusters* by Cluster Size, 

United States, 2020–2022

* Clusters have two or more cases with matching whole-genome multilocus sequence type (wgMLSType) within a county during the specified 3-year time period.
TB Genotype Clusters by TB GIMS* Alert Levels,† United States, 

2020–2022 (N=987)

High alert, 8%

Medium alert, 48%

No alert, 44%

* TB GIMS=Tuberculosis Genotyping Information Management System

† Alert levels are based on a log-likelihood ratio (LLR), which calculates the geographical concentration of a genotype in a county compared to the rest of the country during a 3-year period. 

TB GIMS generates alert level notifications based on this statistic: “No alert” is indicated if LLR is between 0–<4, “medium” is for LLR of 4–<10 and “high” alert is for clusters with LLR ≥10.
Percentage of Clustered TB Cases in Alert and No Alert Genotype Clusters 

by Origin of Birth,* United States, 2020–2022

* Cases with unknown origin of birth not shown (n=14).

† No alert indicates the case was in a cluster with a log-likelihood ratio (LLR) of <4.

§ Alert indicates the case was in a cluster with an LLR of ≥4.

U.S.-born, 

62%

Non-U.S.–born, 

38%

U.S.-born, 

45%

Non-U.S.–born, 

55%

Alert§

(N=1,970)

No alert†

(N=1,029)
Percentage of Clustered TB Cases in Alerted Clusters by 

Age Group,United States, 2020–2022

79%

73%

66%

66%

65%

61%

0–4 years (N=106)

5–14 years (N=75)

15–24 years (N=419)

25–44 years (N=1,038)

45–64 years (N=989)

≥65 years (N=372)
Percentage of Clustered TB Cases in Alerted Clusters by 

Race/Ethnicity Group,* United States, 2020–2022

96%

76%

72%

68%

65%

54%

79%

66%

American Indian or Alaska Native (N=128)

Black or African American (N=824)

Native Hawaiian or

Other Pacific Islander (N=142)

 White (N=300)

Asian (N=316)

Hispanic or Latino (N=1,232)

Multiple race (N=28)

Unknown or missing (N=29)

*Persons who identified as Hispanic or Latino were categorized as "Hispanic," regardless of self-reported race. Persons who did not identify as Hispanic or Latino were categorized by self-reported 

race; if more than one race was reported, the person was categorized as "Multiple race."
Percentage of Clustered TB Cases in Alerted Clusters by 

Selected Risk Factors,United States, 2020–2022

75%

74%

72%

71%

64%

63%

Diagnosed while incarcerated (N=164)

Injecting drug use (N=91)

Excess alcohol use (N=509)

Noninjecting drug use (N=559)

Experiencing homelessness (N=318)

Living with HIV (N=169)
The findings and conclusions in this report are those of the authors and do not necessarily 

represent the official position of the Centers for Disease Control and Prevention.

Division of Tuberculosis Elimination 

National Center for HIV, Viral Hepatitis, STD, and TB Prevention

Centers for Disease Control and Prevention 

1600 Clifton Road NE

Atlanta, GA 30329

Phone: 404-639-8120

E-mail: tbinfo@cdc.gov

Internet Address: http://www.cdc.gov/tb/